Declaration on
health and welfare in Southern Africa
Maputo, April 15,1990
This Maputo Conference, an Interna- tional Conference on Health in Southern Africa, held between April 9-75,1990,
has been a unique and unprecedented event at a moment of historic opportunity for the liberation struggle.
This meeting has had a special and remarkable character for three reasons.
1. It has brought together for the first time health and social welfare workers, anti-apartheid activists from the United States of America, the United Kingdom and other countries, organisations rep- resenting more than 54 000 health work- ers from within South Africa, and their counterparts and comrades from the ANC, Mozambique and all of the Frontline States.
2. It has addressed the urgent challenge, in this final and decisive stage of the liberation struggle, of formulating spe- cific proposals, strategies and policies for the structure, organisation,financing
and development of health and welfare services for a truly democratic South Africa.
3. Of further political significance, the Maputo Conference has been an expres- sion of the Mozambique government's solidarity with progressive forces in South Africa, a recognition of our shared expe-
rience of the tyranny of apartheid and our mutual abhorrence of the deliberate destabilisation of Mozambique, and in particular of the appalling atrocities per- petrated by the apartheid regime. This shared experience - including the delib-
erate apartheid effort, both within and outside South Africa, to destroy the po- tential for full development of entire generations - united us as brothers and sisters.
This conference commits itself to:
• Transforming the existing health and social services in South Africa into a non-racial, accessible, equitable, cost- effective and democratic national health and welfare system.
• Promoting a new vision of health and welfare services as a tool of national development
• Devising an appropriate social welfare policy for a future South Africa and to placing the development of this policy high on the agenda of the national libera- tion movement
• Prioritising the development of a pro- gressive primary care strategy as the basis for the provision of health and welfare services.
• Emphasising the importance of mak- ing realistic assessments of the resources required to meet national health and welfare needs equitably, and of research- ing means for mobilising such resources.
In line with the above commitments, high priority must be placed on applied health and welfare research and training.
Communities, political organisations and research groupings should be mobilised to achieve this in the shortest possible time.
The conference devoted particular attention to the problems of Financing future national health and welfare sys- tems in South Africa, and recognised the need for further research. These debates need to be placed in the context of the specific characteristics of a mixed econ- omy. Discussions around the role of the private health and welfare sector should be extended through health and commu- nity organisations, taking cognisance of effective international models.
Adequate primary health care and welfare services will require appropriate
personnel. The conference stressed the need for research and training, for the integration of ANC health workers at every level into the health sector, and for understanding of the role of traditional healers.
The participants are unanimous in their belief that the training and educa- tion of health and welfare workers is most effective and appropriate when it is situated in the community, and achieved through problem-based learning meth- ods. The problems of accredition of health professionals trained by different meth- ods and through different institutions both within and outside South Africa, has to be addressed with the relevant authori- ties in order to maximise opportunities for employment of these individuals.
All delegates to the conference bene- fitted considerably from presentations of experiences in health and welfare serv- ices in the Frontline States. Some of these experiences, which have a direct bearing on the reconstruction of South Africa's health and social services, must be more fully explored. Everyone is fully committed to enhancing the quality of life of all the people of the Southern African subcontinent through regional cooperative endeavours, which would be encouraged and established once South Africa has obtained independence, de- mocracy and freedom.
A number of issues of urgent priority were identified. This conference affirms the need to integrate women into all health and welfare initiatives, and points out that every proposal must specifically examine the consequences for women.
The conference takes particular cognisance of the needs of children and families, and the damage that has been done to them by apartheid. That damage must be reversed.
Hie worth and dignity of family life must
4 / August 1990 - CRITICAL HEM Iff
be restored Childhood must be reclaimed.
Tne conference stresses the importance of the health and welfare of workers, not only on the factory floor and the rural farm, but also in relation to the appalling community and environmental conditions which must be massively improved. To address the urgent problem of the return to South Africa of more than 20 000 exiles, the conference endorses the for-
mation of a National Reception Commit- tee, through which the ANC together with other progressive mass-based or- ganisations, can work outconcrete meas-
ures for the rapid and effective integra- tion of returnees into South African so- cial, political and economic life.
All those present are acutely aware that South Africa and indeed the entire Southern African region is facing a crisis over the HIV epidemic. Urgent action
must be initiated immediately, as the State's programmes arc fundamentally limited and seriously flawed. Commu-
nity-based initiatives are known to be more effective since they pay attention to the broader psycho-social implications of the disease. An alternative progressive campaign with the support of political and other representative organisations has to be set up immediately. An AIDS Task Force with strong political leader- ship is proposed to take this programme forward.
Finally, this Conference expresses our hope, our determination and our confi- dence.
Our hope is derived from the fact that all the nations in the region are accom- plishing the complete decolonisation of the subcontinent of Southern Africa. The independence of Namibia is a recent example.
Our determination is to eradicate the last vestiges of racial oppression and colonial exploitation from the entire region.
Our confidence stems from our ca- pacity for unity which has been affirmed
by the common sense of purpose which has brought together people from many nations, many origins and backgrounds, and many disciplines to address the short and longer-term tasks of charting the future of a truly democratic South Af- rica. Q
Delegates to the Maputo Conference.
Issued by the
Conference Organising Groups:
The African National Congress; National Education Health and Allied Workers Un-
ion. National Medical and Denial Associa- tion; Organisation for Appropriate Social Services in Soulh Africa; South African
Health Workers Congress; Welfare Coordi- nating Committee; Ministry of Health.
Mozambique: Commitlec for Heahh in Southern Africa (USA); Representatives from ihe WHO Collaborating Centre for Community Based Medical Education at the University of New Mexico; Ami-Apartheid
Movement (London).
Other participants were:
The Deans of the medical schools of the I'm versiiies of: Edouard Mondlane, Mozam- bique; Ilorin. Nigeria; Newcastle. Australia;
Zambia.
Representatives from the Frontline States:
Angola. Namibia. Tanzania, Zambia.
Representatives from FREUMO, the WHO representative. Maputo; other Mozambican participants.
Representatives from the following internal South African organisations:
Congress of South African Trade Unions - health and safety group; Concerned Social Workers; Critical Health publication; Health Workers Society; Health Workers Union;
Industrial Health and Safety Service Organ- isations; Islamic Medical Association; Na- tional Interim Women's Croup; National Union of Students; Progressive Primary Health Care Network; Social Workers Fo- rum; South African Black Social Workers Association; South African Council of Churches; South African National Students Congress; United Democratic Front.
CRITICAL HEAL TH - August 1990 / S
